Supplemental Exam 1 Flashcards
What happens in week 13-16 of the fetal stage of pregnancy?
oogenesis is established in females, blood vessels are visible, ridges near fingers, hand and feet appear.
What happens in week 20 of the fetal stage?
vernix and lanugo appear + fetal swallowing + insulin
What happens in week 24 of the fetal stage?
surfactant is produced
What happens in week 28 of the fetal stage?
testes descend + head moves into the downward position + blood is produced in the bone marrow
What is the size of the placenta ?
2.5-3 cm thick and 38-51 cm in diameter
What are the 3 primary functions of the placenta?
hormone production, protection and circulation
What carries oxygenated blood to the fetus/embryo?
1 large vein
What carries deoxygenated blood to the placenta?
2 smaller arteries
What is the substance that covers the umbilical cord to protect and support the blood vessels?
Wharton Jelly
What hormone increases in the second trimester to promote neurological and lung development?
cortisol
Normal pregnancy Hct level?
30-39
Normal pregnancy Hgb level?
11-13
Between the 16th and 36th week of pregnancy what will the size of the uterus be?
It will match weeks gestations from the symphis pubis to the fundus.
What can too much weight gain in pregnancy lead to ?
induced HTN and increased risk for c section
When should headaches be evaluated in pregnancy?
after 20 weeks
How often should prenatal appointments be the first 28 weeks of pregnancy?
every 4 weeks
How often should prenatal appointments be from 28-36 weeks?
every two weeks
After 36 weeks how often should prenatal appointments be?
every week
What are the 3 levels to contractions?
Increment: build up phase
Acme: peak
Decrement: relaxation phase
What is the introitus?
the opening of the vagina
Gynecoid pelvis
shape provides the most ideal passageway
What helps orient the fetus through the cardinal movements?
pelvic floor muscles
Vertex attitude
full flexion (best way)
Sinciput attitude
moderate flexion
brow attitude
partial extension
face attitude
poor flexion and complete extension
What are some true signs of labor:
-regular contractions
-bloody show presence
-decent of the fetus into the canal (lightening)
-nesting
-GI distress
-Wt loss of 1-3 lbs
What happens during the Latent Phase of labor?
-longest phase
-period of excitement
-contractions feel like menstral cramps and are mild to palpation
What happens during the active phase of labor?
-pt becomes more anxious, focused, or restless
-contractions become more regular and painful
-contractions are moderately strong
What happens during the transition phase?
-contractions are strong and close
-pt may feel out of control, irritable or independent
-shortest phase
Engagement
head reaches the ischeal spine
Descent
head moves past the ischeal spine
flexion
fetal chin touches chest in response from pressure of maternal tissue
internal rotation
fetal head rotates
extension
fetal chin comes off the chest and arches as the head is born
external rotation (restitution)
fetal head is born and rotates again as shoulders move position for birth
expulsion
body of the fetus is born
How long does the 2nd stage of labor last?
20 minutes - 2 hours
How long does the 3rd stage of labor last?
5-10 minutes (try to keep no longer than 30)
Uterine atony
the failure of the uterus to contract
How long should continuous monitoring be preformed in the 1st stage of labor?
every 30 minutes
How long should continuous fetal monitoring occur in the 2nd stage of labor?
every 15 minutes
What is the baseline heart rate for a fetus in the womb?
110-160 bpm
Variability
irregular fluctuations in fetal baseline
Moderate Variabiltiy
has an amplitude of 6-25 bpm and is assessed over 10 minutes
Accelerations
an increase of baseline of at least 15x15
Late Decels
indicates a decrease in perfusion
Variable Decels
indicate cord compression
Early Decels
indicate heads compression
Prolonged Decels
indicate a decrease of at lease 15 bpm that last 2-15 minutes
What are the interventions for late, prolonged, or variable decels
-maternal position change
-discontinue oxytocin
-administer 8-10 L by nonrebreather
-correct hypotention
-notify provider
Category 1
-normal baseline
-with or w/o decels
-with or w/o accelerations
-no variable decels
-no late decels
-moderate variability
Category 3
-absent variability with reccurent variable decels
-absent variability with recurrent late decels
-absent variability with bradycardia
-sinosodial pattern
Uterine Tachysystole
5 or more contractions in 10 minutes averages over 30 minutes
What are some factors that influence labor pain tolerance?
-fear
-previous labor pain
-support
-fatigue
How long does it take most pregnancy changes to go back to normal?
6 weeks
Involution
shrinking of uterus back to its original size
Why does the uterus contract even after birth?
to prevent from hemmoraging
Lochia Rubia
-dark red
-3-4 days
-clots larger than plums are abnormal
Lochia serosa
-light pink or brown
-10-14 days
Lochia alba
-yellow or white
-2-4 weeks
How much blood is typically lost during a vaginal birth?
200-500 ml
How much blood is lost during a c-section?
500-1000ml
Taking in phase
when the patient is recovering and takes a passive, dependent role
Taking hold phase
when the patient processes the birth experience and transitions into a more dependent role
Letting go phase
when the patient acknowledges the new normal and sees the baby as a person and not as an idea
What does BUBBLEE-E stand for ?
Breasts, Uterus, Bladder, Bowels, Lochia, Extremities, Episiotomy, and Emotion
What are some complications of a C-section?
-endometriosis
-surgical wounds (dehiscence, infections and hematoma)
-hemmorhage
-surgical injury
-clots
Evaporation
heat loss due to the evaporation of liquids from the body.
dry thoroughly after birth, stabilize temp, bathe in a warm environment
Conduction
transfer of heat by a direct content w/ a cooler object
Place in pre-warmed surfaces
Convection
heat transfer from a new born to surrounding air
Radiation
transfer of heat from or to the newborn from or to nearby surfaces
keep away from cool windows or walls
Apgar assessment
immediately after birth and stands for apperance, pulse, grimace, activity and respirations
